Respiratory Disorders

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Bronchial Asthma

Asthma is a condition caused by constriction of the lower air passages of the lungs. Cause may be unknown, but a hypersensitive (allergic) reaction, environment pollutants, genetic predisposition and infectious agents are likely. Some cases may result from inhaling cat litter dust. Signs may include coughing, wheezing, dyspnea (difficulty breathing) and gagging. Diagnosis is afforded via physical exam, radiography, complete blood count, electrocardiography, tracheobronchial wash, cytology, bronchoscopy, culture and sensitivity. Treatment may include bronchodilators, antibiotics, corticosteroids and supportive care. Extreme cases may necessitate emergency care!

Bronchitis

The major respiratory air passages include the trachea (windpipe), bronchi and bronchioles. They direct air into the lungs, exchange oxygen and carbon dioxide and then convey exhaled air back to the outside. Bronchitis is an inflammation of the bronchi and bronchioles. Tracheitis is inflammation of the trachea. Because the trachea, bronchi and bronchioles are connected, insults to one may affect the others (eg. tracheobronchitis). Causes include anatomical disorders (eg. ciliary dyskinesis), metabolic disease, neoplasia, bacterial, viral and parasitic infections, irritants, heart disease, trauma and toxins. Signs may include cough, rapid breathing, gagging and wheezing. Diagnosis is afforded via history, physical exam, radiographs, bronchoscopy, tracheal wash, cytology, complete blood count, culture and sensitivity. Treatment may include antitussives, antibiotics, bronchodilators, anti-inflammatories and supportive care.

Chylothorax

Chylothorax is an accumulation of a milky fluid (chyle) in the chest cavity (thorax). The fluid contains lymphocytes, other white blood cells and triglycerides being transported by lymph ducts and the main lymph duct of the chest (thoracic duct) to the heart. Leakage from the thoracic duct causes chylothorax. Causes include trauma, birth defects, heart disease, neoplasia and parasites (heartworms). This fluid compresses the lungs, making it difficult for the lungs to expand. Signs may include lethargy, anorexia, coughing and dyspnea (difficulty breathing). Diagnosis is afforded via physical exam, chest tap, cytology, complete blood count, blood chemistries, serology, radiography and ultrasound. Treatment may include drainage of the fluid, surgery and medical management.

Elongated Soft Palate

The soft palate is the rear, soft roof of the mouth. Some pets are born with an abnormally long soft palate that covers the windpipe opening to various degrees. Dogs with ‘pushed-in” noses, such as Pekingese, Pugs, Boston Terriers and Bulldogs are over represented. The elongated palate may become inflamed and swollen which further impairs breathing. Signs include coughing, difficult and/or noisy breathing, frequently gagging or choking and difficult swallowing. Diagnosis is afforded via physical exam, rigid scope exam and imaging studies. Treatment may include anti-inflammatories, cough suppressants and surgery.

Pneumonia

Pneumonia is a general term for lung inflammation. Causes include bacterial, viral and fungal infections, allergies, neoplasia, parasites, inhaled irritants, foreign materials, trauma and toxins. Signs may include fever, coughing, anorexia, depression and listlessness. Diagnosis is afforded via physical exam, complete blood count and radiography. Treatment may include anti-inflammatories, antibiotics, antifungals, bronchodilators, expectorants, cough suppressants and oxygen. It should be noted that in weakened pets, upper respiratory diseases may spread to the lungs and cause pneumonia. Pets immobilized for long periods of time from illness or injury are at risk to develop pneumonia.

Pneumothorax

Pneumothorax is a disorder in which air escapes into the chest via a defect in the lungs or chest wall. In either case, the lungs are unable to expand. Signs include depression, listlessness and difficulty breathing. Diagnosis is afforded via physical exam and radiography. Treatment may include supportive care, medical therapy and surgery.

Pulmonary Emphysema

Pulmonary emphysema is a disorder in which small air sacs in the lungs (alveoli) break down. Causes include inflammation, infection, irritants, toxins and tumors of the respiratory tract. This traps air within the lungs causing labored breathing, shortness of breath on exertion, coughing and wheezing. Diagnosis is afforded via physical exam, biopsy and radiography. Treatment is directed at the underlying cause and may also include corticosteroids and oxygen.

Pyothorax

Pyothorax is an accumulation of pus in the chest cavity secondary to penetrating chest wounds and/or spread of infection from elsewhere in the body. Accumulated pus (mixture of white blood cells, bacteria and debris) both crowds the lungs as well as may release toxins into the body. Signs may include fever, difficulty breathing, depression, listlessness, anorexia and collapse. Diagnosis is afforded via physical exam, chest tap, cytology, radiography, complete blood count, culture and sensitivity. Treatment may include antibiotics, chest drainage, chest lavage, oxygen and supportive care.

Respiratory Tract Obstructions

Clear passage from the nose and/or mouth to the lungs is necessary for normal breathing. Obstructed breathing may be caused by birth defects, tumors, inhaled objects, and infection. Signs include anorexia, coughing, listlessness and difficulty breathing. Diagnosis is afforded via physical exam, endoscopy, cytology, imaging studies, culture and sensitivity. Treatment is directed at the underlying cause.

Reverse Sneeze Syndrome

Reverse sneeze syndrome is characterized by rapid, loud, forced inhalations causing the dog to usually stand still with neck extended. There is no loss of consciousness or collapse. Attacks are sporadic and unpredictable. Dogs appear completely normal before and after the attack. Many dogs have these attacks throughout their lives and appear to be aggravated with dust, pressure on the windpipe or during pollen seasons. Treatment consists of minimizing the aggravating components. Rubbing the neck under the chin usually stops the attack.

Sinusitis

Sinuses are bony cavities in the skull that communicate with the nasal passages and may act as insulators and resonators of the voice. The roots of some upper teeth extend into the sinuses. Advanced periodontal disease and/or tooth abscesses may cause sinus infections. Sinus infections may produce eye or nose discharge, coughing, reverse sneeze and/or other respiratory infections. Diagnosis is afforded via radiography. Treatment may include antibiotics, anti-inflammatories and/or surgery (trephine).

Stenotic Nares

Stenotic nares are narrowed nostrils and occur most commonly in dogs with “pushed-in” noses, such as Pekingese, Boston Terriers, Bulldogs or Pugs. Signs include difficulty breathing in, noisy inhalation and clear discharge with exhalation. Diagnosis is afforded via physical exam. Treatment may include surgical enlargement of the nasal openings.

Tracheal Collapse

The trachea (windpipe) is composed of C-shaped rings of cartilage that are joined by muscle and ligaments to create a tube-like structure. Weakening of the muscle and/or the cartilage can result in collapse of the tube with inhalation. The condition is seen mostly in old, overweight toy breeds. Causes include degenerative disorders, congenital defects (present at birth), hypothyroidism, neurologic disorders, immune mediated disease, trauma and toxins. Signs include difficulty inhaling, reluctance to be active and fainting or collapsing. Diagnosis is afforded via physical exam, endoscopy and radiography. Treatment may include medical management (eg. bronchodilators, cough suppressants, etc.) and/or surgery.